Venkatram (M/17) non-spectacle wearer, came for eye examination, complaining of frequent headache with near work especially after MCO. He has brought along his eye prescription of cycloplegic refraction, upon prompted he said his eyes were put eye drop a few times before getting the eye power.
Vision without glasses:
R: 6/12
L: 6/12
Examination shows:
R: +0.25/-3.25×180 (6/9)
L: PL/-2.50×180 (6/7.5)
Relax Add: +0.75
Retinoscopy (to check eye power by looking into eye reflex that does not require response from patient)
bright reflex & dim reflex are alternately seen
This autorefractor result indicates fluctuation in his shortsighted power, that seems to tally with unstable accommodation/focusing seen in retinoscopy. Bright reflex is seen when his accommodation is engaged where as dim reflex suggests that his accommodation is fired suboptimally giving the fluctuation.
With such high astigmatism, he needs to wear his glasses fulltime. Excessive near work during MCO exhausted his eyes, on top of very high uncorrected astigmatism, eventually causing persistent headache.
Venkatram will wear the new glasses fulltime and we will see him again in 4-6weeks.